Cardiovascular outcomes after simultaneous pancreas kidney transplantation compared to kidney transplantation alone: a propensity score matching analysis.

BACKGROUND: Coronary heart disease due to arteriosclerosis is the leading cause of death in type 1 diabetic patients with end-stage renal disease (ESRD). The aim of this study was to evaluate the effect of simultaneous pancreas kidney transplantation (SPKT) compared to kidney transplantation alone (KTA) on survival, cardiovascular function and metabolic outcomes. METHODS: A cohort of 127 insulin-dependent diabetes mellitus (IDDM) patients with ESRD who underwent either SPKT (n = 100) or KTA (n = 27) between 1998 and 2019 at the University Hospital of Leipzig were retrospectively evaluated with regard to cardiovascular and metabolic function/outcomes as well as survival rates. An additional focus was placed on the echocardiographic assessment of systolic and diastolic cardiac function pretransplant and during follow-up. To avoid selection bias, a 2:1 propensity score matching analysis (PSM) was performed. RESULTS: After PSM, a total of 63 patients were identified; 42 patients underwent SPKT, and 21 patients received KTA. Compared with the KTA group, SPKT recipients received organs from younger donors (p < 0.05) and donor BMI was higher (p = 0.09). The risk factor-adjusted hazard ratio for mortality in SPKT recipients compared to KTA recipients was 0.63 (CI: 0.49-0.89; P < 0.05). The incidence of pretransplant cardiovascular events was higher in the KTA group (KTA: n = 10, 47% versus SPKT: n = 10, 23%; p = 0.06), but this difference was not significant. However, the occurrence of cardiovascular events in the SPKT group (n = 3, 7%) was significantly diminished after transplantation compared to that in the KTA recipients (n = 6, 28%; p = 0.02). The cardiovascular death rate was higher in KTA recipients (19%) than in SPK recipients with functioning grafts (3.3%) and comparable to that in patients with failed SPKT (16.7%) (p = 0.16). In line with pretransplant values, SPKT recipients showed significant improvements in Hb1ac values (p = 0.001), blood pressure control (p = < 0.005) and low-density lipoprotein/high-density lipoprotein (LDL/HDL) ratio (p = < 0.005) 5 years after transplantation. With regard to echocardiographic assessment, SPKT recipients showed significant improvements in left ventricular systolic parameters during follow-up. CONCLUSIONS: Normoglycaemia and improvement of lipid metabolism and blood pressure control achieved by successful SPKT are associated with beneficial effects on survival, cardiovascular outcomes and systolic left ventricular cardiac function. Future studies with larger samples are needed to make predictions regarding cardiovascular events and graft survival.

Universal size-dependent conductance fluctuations in disordered organic semiconductors.

Numerically exact results of hopping charge transport in disordered organic semiconductors show for uncorrelated and dipole-correlated Gaussian energy disorder a universal, power-law, and non-power-law dependence, respectively, of the relative conductance fluctuations on the size of the considered region. Data collapse occurs upon scaling with a characteristic length having a power-law temperature dependence. Below this length, which can be as high as 100 nm for correlated disorder in a realistic case, fluctuations dominate and a continuum description of charge transport breaks down.

Ultrahigh magnetoresistance at room temperature in molecular wires.

Systems featuring large magnetoresistance (MR) at room temperature and in small magnetic fields are attractive owing to their potential for applications in magnetic field sensing and data storage. Usually, the magnetic properties of materials are exploited to achieve large MR effects. Here, we report on an exceptionally large (>2000%), room-temperature, small-field (a few millitesla) MR effect in one-dimensional, nonmagnetic systems formed by molecular wires embedded in a zeolite host crystal. This ultrahigh MR effect is ascribed to spin blockade in one-dimensional electron transport. Its generic nature offers very good perspectives to exploit the effect in a wide range of low-dimensional systems.

Scaling theory for percolative charge transport in disordered molecular semiconductors.

We present a scaling theory for charge transport in disordered molecular semiconductors that extends percolation theory by including bonds with conductances close to the percolating one in the random-resistor network representing charge hopping. A general and compact expression is given for the charge mobility for Miller-Abrahams and Marcus hopping on different lattices with Gaussian energy disorder, with parameters determined from numerically exact results. The charge-concentration dependence is universal. The model-specific temperature dependence can be used to distinguish between the hopping models.

Spin-spin interactions in organic magnetoresistance probed by angle-dependent measurements.

The dependence of organic magnetoresistance (OMAR) on the orientation of the magnetic field has been investigated. In contrast with previous claims, a finite and systematic change in magnitude is observed when the orientation of the field is changed with respect to the sample. It is demonstrated that, to explain these effects, spin-spin interactions have to be included in the models previously suggested for OMAR. Dipole coupling and exchange coupling are introduced in combination with either an anisotropy of the orientation of the spin pairs or an anisotropy in the hyperfine fields.

Magnetic-field dependence of the electroluminescence of organic light-emitting diodes: a competition between exciton formation and spin mixing.

We explore the magnetoelectroluminescence (MEL) of organic light-emitting diodes by evaluating the magnetic-field dependent fraction of singlet excitons formed. We use two- and multisite polaron-hopping models with spin mixing by hyperfine fields and different singlet and triplet exciton formation rates k(S) and k(T). A huge MEL is predicted when exciton formation is in competition with spin mixing and when k(T) is significantly larger than k(S). This competition also leads to a low-field structure in the MEL that is in agreement with recent experiments.

Magnetoresistance in hybrid organic spin valves at the onset of multiple-step tunneling.

By combining experiments with simple model calculations, we obtain new insight in spin transport through hybrid, CoFeB/Al2O3(1.5 nm)/tris(8-hydroxyquinoline)aluminium (Alq3)/Co spin valves. We have measured the characteristic changes in the I-V behavior as well as the intrinsic loss of magnetoresistance at the onset of multiple-step tunneling. In the regime of multiple-step tunneling, under the condition of low hopping rates, spin precession in the presence of hyperfine coupling is conjectured to be the relevant source of spin relaxation. A quantitative analysis leads to the prediction of a symmetric magnetoresistance around zero magnetic field in addition to the hysteretic magnetoresistance curves, which are indeed observed in our experiments.

Theory for spin diffusion in disordered organic semiconductors.

We present a theory for spin diffusion in disordered organic semiconductors, based on incoherent hopping of a charge carrier and coherent precession of its spin in an effective magnetic field, composed of the random hyperfine field of hydrogen nuclei and an applied magnetic field. From Monte Carlo simulations and an analysis of the waiting-time distribution of the carrier we predict a surprisingly weak temperature dependence, but a considerable magnetic-field dependence of the spin-diffusion length. We show that both predictions are in agreement with experiments on organic spin valves.

High molecular weight adiponectin correlates positively with myeloperoxidase in patients with type 2 diabetes mellitus.

Adiponectin (APN) is present in human plasma as a low molecular weight (LMW), a middle molecular weight (MMW) and a high molecular weight form (HMW). As a support to determine properties such as anti-atherogenic or atherogenic effects, recent clinical studies suppose to determine the ratio of each APN multimer to total APN but not the absolute plasma concentration of APN. In the present study, the correlation of APN and its multimers with myeloperoxidase (MPO), an enzyme with pro-inflammatory properties, was examined in patients with type 2 diabetes mellitus. MPO and APN serum levels were assessed in 49 patients with type 2 diabetes mellitus at the beginning and at the end of an anti-diabetic treatment. After treatment a significant increase in the ratio of HMW to total APN (from 0.43+/-0.16 to 0.59+/-0.14, p<0.05) was found. Before treatment, HMW-APN was correlated positively with MPO (r=0.314, p<0.05). Moreover, a positive correlation was observed between the increased HMW ratio and MPO during treatment (r=0.304, p<0.05). HMW-APN correlates positively with MPO in patients with type 2 diabetes. Therefore, HMW-APN may exert possible pro-inflammatory effects in type 2 diabetes.

Bipolaron mechanism for organic magnetoresistance.

We present a mechanism for the recently discovered magnetoresistance in disordered pi-conjugated materials, based on hopping of polarons and bipolaron formation, in the presence of the random hyperfine fields of the hydrogen nuclei and an external magnetic field. Within a simple model we describe the magnetic field dependence of the bipolaron density. Monte Carlo simulations including on-site and longer-range Coulomb repulsion show how this leads to positive and negative magnetoresistance. Depending on the branching ratio between bipolaron formation or dissociation and hopping rates, two different line shapes in excellent agreement with experiment are obtained.

Unified description of charge-carrier mobilities in disordered semiconducting polymers.

From a numerical solution of the master equation for hopping transport in a disordered energy landscape with a Gaussian density of states, we determine the dependence of the charge-carrier mobility on temperature, carrier density, and electric field. Experimental current-voltage characteristics in devices based on semiconducting polymers are excellently reproduced with this unified description of the mobility. At room temperature it is mainly the dependence on carrier density that plays an important role, whereas at low temperatures and high fields the electric field dependence becomes important. Omission in the past of the carrier-density dependence has led to an underestimation of the hopping distance and the width of the density of states in these polymers.

CaB6: a new semiconducting material for spin electronics.

Ferromagnetism was recently observed at unexpectedly high temperatures in La-doped CaB6. The starting point of all theoretical proposals to explain this observation is a semimetallic electronic structure calculated for CaB6 within the local density approximation. Here we report the results of parameter-free quasiparticle calculations of the single-particle excitation spectrum which show that CaB6 is not a semimetal but a semiconductor with a band gap of 0.8+/-0.1 eV. Magnetism in La(x)Ca1-xB6 occurs just on the metallic side of a Mott transition in the La-induced impurity band.

Parameter-free quasiparticle calculations for YH3.

Electronic structure calculations for YH3 within the local density approximation result in a metallic ground state with the bands at the Fermi energy overlapping by more than 1 eV, whereas a band gap of 2.8 eV is deduced from optical experiments. Here, we report the results of parameter-free GW calculations which predict a fundamental gap of 1 eV. When we take into account electric dipole matrix elements a large optical gap of almost 3 eV is obtained. A combination of photoemission and inverse photoemission spectroscopy could test the prediction of a small fundamental band gap.